John B. v. Dave Goetz
2010 U.S. App. LEXIS 24438
6th Cir.2010Background
- 1998 42 U.S.C. §1983 class action challenging TennCare EPSDT implementation in Tennessee; district court entered a consent decree establishing systemic EPSDT remedies, including service provision, outreach, and geographic comparability requirements.
- Plaintiffs allege state defendants failed to provide EPSDT services and information, violating §1396a(a)(43) and related Medicaid provisions; consent decree embodies these remedial obligations.
- Defendants seek to vacate the decree under Rule 60(b) due to intervening case law limiting privately enforceable rights under the Medicaid Act and to have the case reassigned.
- Westside Mothers II (2006) held some §1396a(a)(43) provisions are enforceable under §1983 while others are not, affecting the decree’s private enforceability.
- Brown (2009) vacated parts of prior relief tied to waiting lists and provider networks but left others intact; this guided district court’s remand and partial vacatur analysis.
- Court ultimately vacates the portion of the decree based on §1396a(a)(30) and remands for reassignment and further proceedings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Private enforceability of §1396a(a)(43) rights under §1983 | Westside Mothers II holds at least §1396a(a)(43)(A) privately enforceable; decree should remain. | §1396a(a)(43) rights are not privately enforceable; decree should be vacated or narrowed. | Some enforceable rights remain; partial vacatur permitted. |
| Whether entire decree should be vacated or only unenforceable provisions | Decree largely enforceable; only unenforceable parts vacated. | Decree largely unenforceable overall; vacate entire decree. | Vacate only the §1396a(a)(30) provision; remainder potentially enforceable on remand. |
| Appropriate forum for case reassignment | Original judge’s history risks bias or prejudice; reassignment warranted. | Reassignment unnecessary. | Case reassigned to a different judicial officer. |
| Applicability of Westside Mothers II and Brown to other provisions (e.g., waiting lists, outreach) | Westside Mothers II supports outreach/enforcement of information provisions. | Brown narrows or limits other remedies; waiting lists not enforceable. | Remand to district court to address unresolved private enforceability questions with briefing. |
Key Cases Cited
- Westside Mothers v. Olszewski, 454 F.3d 532 (6th Cir. 2006) (affirmed private enforceability of some EPSDT outreach claims; not all provisions)
- Brown v. Tennessee Department of Finance & Administration, 561 F.3d 542 (6th Cir. 2009) (vacated waiting-list and provider-network relief as unenforceable; otherwise allowed continuance of decree)
- Gonzaga University v. Doe, 536 U.S. 273 (Sup. Ct. 2002) (reverses analysis of rights vs. benefits; focus on intent to create enforceable rights)
- Frazar v. Gilbert, 300 F.3d 530 (5th Cir. 2002) (private enforceability issues; later reversed in Frew)
- Frew v. Hawkins, 540 U.S. 431 (Sup. Ct. 2004) (reaffirms rights-focused inquiry under §1983)